Provider Demographics
NPI:1831814706
Name:ZELSNACK, ALYSSA MARIE (LPC)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:MARIE
Last Name:ZELSNACK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 WYOMING AVE STE D
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704-3831
Mailing Address - Country:US
Mailing Address - Phone:570-288-4205
Mailing Address - Fax:570-288-4889
Practice Address - Street 1:675 WYOMING AVE STE D
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-3831
Practice Address - Country:US
Practice Address - Phone:570-288-4205
Practice Address - Fax:570-288-4889
Is Sole Proprietor?:No
Enumeration Date:2022-10-04
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC014571101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health